Royal College of Surgeons in Ireland
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Does the shoe really fit? Characterising ill-fitting footwear among community dwelling older adults: an observational cross-sectional study

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posted on 2022-04-29, 08:53 authored by Brian O'Rourke, Mary Walsh, Rachael Brophy, Shanice Vallely, Niamh Murphy, Bronagh Conroy, Conal Cunningham, Frances HorganFrances Horgan

Background: Falls in older people are common and can result in loss of confidence, fear of falling, restriction in activity and loss of independence. Causes of falls are multi-factorial. There is a paucity of research assessing the footwear characteristics among older people who are at high risk of falls, internationally and in the Irish setting. The aim of this study was to examine the proportion of older adults attending a geriatric day hospital in Ireland who were wearing incorrectly sized shoes.

Methods: A consecutive sample of 111 older adults aged 60 years and over attending a geriatric day hospital in a large Irish teaching hospital was recruited. Demographic data including age, mobility, medications, co-habitation status, footwear worn at home and falls history were recorded. Shoe size and foot length were measured in millimetres using an internal shoe gauge and SATRA shoe size stick, respectively. Participants' self-reported shoe size was recorded. Footwear was assessed using the Footwear Assessment Form (FAF). A Timed Up and Go (TUG) score was recorded. Functional independence was assessed using the Nottingham Extended Activities of Daily Living (NEADL) Scale. The primary outcome of interest in this study was selected as having footwear within the suggested range (10 to 15 mm) on at least one foot. Participants who met this definition were compared to those with ill-fitting footwear on both feet using Chi-square tests, T-tests or Mann-Whitney U tests.

Results: The mean difference between shoe length and foot length was 18.6 mm (SD: 9.6 mm). Overall, 72% of participants were wearing footwear that did not fit correctly on both feet, 90% had shoes with smooth, partly worn or fully worn sole treading and 67% reported wearing slippers at home. Participant age, TUG score and NEADL score were not associated with ill-fitting footwear.

Conclusions: Wearing incorrectly fitting shoes and shoes with unsafe features was common among older adults attending geriatric day services in this study. A large number of participants reported wearing slippers at home.


Research Summer School (RSS) Programme Award (2017) from the Royal College of Surgeons in Ireland



The original article is available at Published version is available in BMC Geriatrics and RCSI repository

Published Citation

O'Rourke B. et al. Does the shoe really fit? Characterising ill-fitting footwear among community-dwelling older adults attending geriatric services: an observational cross-sectional study. Research Square 2020

Publication Date

15 January 2020

PubMed ID



  • General Practice
  • HRB Centre for Primary Care Research
  • School of Physiotherapy

Research Area

  • Population Health and Health Services


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  • Submitted Version (Preprint)